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Heart Experts Cast Doubt on Claims That Russian Skater’s Drug Test Was Contaminated by Her Grandfather’s Medicine

Beijing 2022 Olympic Games

Kamila Valieva of the Russian Olympic Committee (ROC), performs in the course of the Women’s Single Skating Short Program on day eleven of the Beijing 2022 Winter Olympic Games on Feb. 15, 2022 in Beijing. Credit – Nikolay Muratkin–Anadolu Agency/Getty Images

The newest revelations about Russian figure skater Kamila Valieva’s doping case elevate extra questions concerning the substances present in her pattern—and the explanations why the 15-year-old might have failed the drug test. TIME requested main consultants to assist make sense of the claims, which have upended the ladies’s determine skating competitors on the Beijing Olympics and cast a larger pall over the game.

At the listening to held on Sunday by the Court of Arbitration for Sport (CAS), anti-doping authorities revealed that Valieva examined constructive for 3 coronary heart therapy medicine, one in every of which is banned as a performance-enhancer by the World Anti-Doping Agency.

In addition to trimetazidine (TMZ), the prohibited substance, the New York Times reported that Valieva’s pattern additionally contained hypoxen and L-carnatine, a complement. All three are used for sufferers with angina, to enhance blood circulate and improve perform of the center when it lacks oxygen.

When she submitted a pattern for testing in December, Valieva declared that she was taking hypoxen and L-carnatine, together with one other compound, supradyn, a complement that enhances immunity, in response to paperwork reviewed by the Times. All three of these substances are allowed.

To clarify the presence of the prohibited drug, TMZ, Valieva’s lawyer argued that she was “contaminated” with the remedy, doubtlessly through contact together with her grandfather, who appeared by video to say that he takes the remedy. TMZ is prescribed to deal with angina, as a result of it might assist improve blood circulate to the center and assist the center to work extra effectively. It’s not accredited within the U.S., however is accredited by the European Medicines Agency and different regulatory our bodies.

READ MORE: Kamila Valieva Is Allowed to Skate. The Battle Over Her Drug Test Is Just Beginning

Russian newspaper Pravda reported that Valieva’s attorneys argued in the course of the listening to, “There can be completely different ways how it got into her body. For example, grandfather drank something from a glass, salvia got in, this glass was somehow later used by an athlete. Or the drug lay down on some surface, traces remained, the drug lay down on this surface, which the athlete then drank.”

Can the drug move that simply from one particular person to a different, and in that case, wouldn’t it seem within the recipient’s urine pattern, as Valieva’s lawyer is claiming? “It reminds me of kids I knew who said they got venereal disease from the toilet seat,” says Dr. Steven Nissen, a heart specialist on the Cleveland Clinic.

Nissen says he’s not conversant in how delicate the assays, a scientific measurement process, getting used by the WADA lab are, however says that testing constructive for a substance by ingesting from the identical glass as somebody taking it’s “very far-fetched.”

“It’s hard to be definitive without knowing the assay [test] sensitivity, but it seems very, very unlikely,” he says.

Valieva’s lawyer additionally claimed she may need come into contact with the remedy on a floor after which one way or the other ingested it. Dr. Donald Lloyd-Jones, president of the American Heart Association and chair of preventive medication at Northwestern University’s Feinberg School of Medicine says, “I’ve seen no evidence it gets absorbed through the skin.” He admits he doesn’t understand how a lot of the drug was detected within the athlete’s pattern, which might inform whether or not a short contact with a small quantity of the drug might clarify her constructive take a look at.

Lloyd-Jones additionally factors out sufferers should take TMZ thrice a day, as a result of it’s metabolized by the physique and excreted comparatively rapidly. Taken on the accredited dose, the drug would attain its peak ranges within the blood in anyplace from two to 6 hours, and the bulk could be cleared inside 24 hours. “It would seem implausible that a little bit on a glass or on her skin would have resulted in a positive test unless it happened to be just before she provided the sample,” he says. “One can draw inferences that either the exposure was very recent, very shortly before her test, or that she was exposed more chronically.”

Ideally, a performance-enhancing drug has the identical characteristic. “The ideal performance-enhancing compounds get in to improve performance, then get out without leaving a trace,” says Lloyd-Jones.

READ MORE: Olympians Let Loose on Kamila Valieva and Russian Doping Controversy

While TMZ just isn’t obtainable within the U.S., Nissen says there’s a related drug, ranolazine, that’s accredited by the Food and Drug Administration. That drug additionally shifts the vitality supply that coronary heart cells use from fatty acids to glucose, which is extra environment friendly. “That’s why it works for angina,” says Nissen. “It allows people to do more with less blood flow. Conceivably for an athlete, it would have similar benefit and would make the heart work more efficiently and give them a little edge.”

Lloyd-Jones says this metabolic pathway additionally ends in much less build-up of lactic acid, which may trigger muscle fatigue. “There are data from small trials in patients who have heart failure that that seem to indicate better heart performance for those who have a failing pump,” he says. “But whether that translates into the same benefit in a young, healthy person—I don’t think we know.”

It’s additionally unclear what the implications are of taking these compounds whereas the physique is youthful. “It’s certainly concerning, especially in a young person whose body is still developing,” says Lloyd-Jones. “We really don’t understand the long term effects of changing someone’s physiology at this age.”

While the Court of Arbitration for Sport decided Valieva might compete in Beijing, her doping violation case stays unresolved, pending additional investigation. That means the gold she and her teammates received within the staff occasion, and any medal she wins within the ladies’s occasion might doubtlessly be stripped if anti-doping officers conclude she doped and competed with an unfair benefit.

That will hinge on further testing of a second pattern, offered from the identical urine as her first, that might be analyzed to verify the constructive outcomes from the primary pattern.

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